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Financial and analytical expertise in budget development, physician practice productivity, productivity standards, revenue cycle management, provider relations, scheduling and referral tracking management and all other aspects relating to the management of a dynamic and growing practice.
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Collaborate with Vice President of Compliance and other compliance professionals who oversee compliance related to financial screening, eligibility and enrollment, provider credentialing and payment operations, vendor relations, service delivery contract performance management, benefit design, data privacy and security, medical case management and clinical services.
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Sante Health System provides numerous client services such as billing, claims processing, contracting, credentialing, finance, human resources, information services, marketing/communications, physician services, practice management, provider relations, quality improvement, and utilization management.
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Possessing working experience in Payer or Provider operations (domain areas such as Medical Management, Population Health Management, Utilization Management, Provider Network Management, Value-Based Contracting, Provider Relations, Quality Improvement, Informatics, ACO operations, etc.
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Minimum 3-5 years clinical experience in any of these areas: acute care, home health, physician office management, managed care organization, provider relations, pharmaceutical sales.
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Actively participate in team huddles and contribute to clinical learning. Remain current on clinical knowledge via self-directed learning. The Care Manager supports the implementation of the CareFirst Value Based Care Management program by working with CareFirst members.
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Work closely with health plan leadership, the Chief Medical Officer, other Medical Leadership, Pharmacy Director, clinical staff (including those in utilization management, care management, quality management), and colleagues within network and provider relations, to enhance the delivery of holistic and integrated care.
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Sharecare is the leading digital health company that helps people - no matter where they are in their health journey - unify and manage all their health in one place. Abide by Value Based Care Management Program Description and Guidelines.
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Manage and execute programs that engage patient advocacy and professional provider groups including, but not limited to, disease awareness campaigns, continuing medical education, patient support initiatives, clinical trial recruitment and public policy work.
$187,000 - $242,000ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Oversee all MCO functional areas, including quality management, utilization management, network development and management, provider relations, member outreach and education, member services, contract compliance, and reporting.
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Consult with corporate Chief Medical Officer, Clinical Consultants, and Denials Management Department. Develop educational and community relations plans in consultation with Program Director, Medical Director, and host hospital CEO.
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Represent SCP Health, patient services, and the Hospital to ensure retention of existing referral sources, grow new referrals and volumes by enhancing client, PCP, Patient and Provider Satisfaction, as well as Quality Case Management, Emergency Department, and other facility relations.
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The Provider Performance Manager is a key member of a cross-functional, collaborative organization (which includes Market Provider Performance, Sales, Health Services, Clinical, Stars & Risk Adjustment, Finance, Marketing, Cross-Segment Contracting, Provider Relations, and Network Development & Solutions.
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Licensed Psychologist (LP), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Mental Health Counselor (LMHC), Registered Nurse (RN), or Advanced Practice Registered Nurse (APRN) required.
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Lifepoint Rehabilitation is a leading provider of acute inpatient rehabilitation services with more than 300 hospital-based rehabilitation units, medical/surgical and outpatient therapy settings and more than 30 joint venture inpatient rehabilitation hospitals across the country.
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